Provider Demographics
NPI:1811205677
Name:MARCHAND-CLIFFORD, DARLENE LILLIAN (LCSW-R)
Entity Type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:LILLIAN
Last Name:MARCHAND-CLIFFORD
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 MONROE STREET
Mailing Address - Street 2:
Mailing Address - City:ST. JOHNSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13452-1125
Mailing Address - Country:US
Mailing Address - Phone:518-568-7023
Mailing Address - Fax:518-568-3016
Practice Address - Street 1:61 MONROE ST
Practice Address - Street 2:
Practice Address - City:SAINT JOHNSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13452-1125
Practice Address - Country:US
Practice Address - Phone:518-568-7023
Practice Address - Fax:518-568-3016
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-15
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR046114-11041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical